Important Updates for December 2017

Scroll to read the updates listed below. As always, members are welcome to contact the WOTA office for more information on these and other practice topics.

Forward Health will no longer require Prior Authorization for OT Evaluations or Re-evaluations

Forward Health School-aged Documentation Changes

SSI Medicaid is Moving OT Patients to Managed Care

Forward Health Update

Good news for OTs in Wisconsin. It looks like prior authorization will no longer be required by Forward Health for OT evaluations or re-evaluations in 2018. In addition, school-aged members will have their documentation process streamlined. This means that coordination of care and/or IEP documentation will not be required for initial treatment services. It also means that Elements 16/17 of the Prior Authorization/Therapy Attachment won't be needed to request treatment for school-aged members.

Forward Health School-aged Documentation Changes

School-aged members have access to both school-based and community based OT services. In 2018, these members will have their documentation process streamlined. This means that coordination of care and/or IEP documentation will not be required for initial treatment services. It also means that Elements 16/17 of the Prior Authorization/Therapy Attachment won't be needed to request treatment for school-aged members.

Change for SSI Medicaid Patients

Wisconsin Dept. of Health Services is announcing a change for SSI Medicaid patients. Current OT patients covered by SSI Medicaid will be moved into a Managed Care set-up. This means that your OT practice needs to be working with HMOs in order to bill effectively in 2018. The roll out plan is as follows:

Region I (North):

December 2017: Members will receive a letter with enrollment packets.
January 10, 2018: A town hall meeting will be held at Northcentral Technical College in Wausau
from 1:30-3:30 and 5-7 p.m.

February 2018: Members are auto enrolled

Region III (West Central):

January 2018: Members will receive a letter with enrollment packets.
February 5, 2018: A town hall meeting will take place in LaCrosse
March 2018: Members are auto enrolled

Region V (Southeast):

Feburary 2018: Members will receive a letter with enrollment packets.
March 5, 2018: A town hall meeting will take place in Racine
April 2018: Members are auto enrolled

Region VI (Milwaukee):

March 2018: Members will receive a letter with enrollment packets.
April 2, 2018: A town hall meeting will take place in Milwaukee (2 locations planned)
May 2018: Members are auto enrolled

Region II (Northeast):

April 2018: Members will receive a letter with enrollment packets.
May 7, 2018: A town hall meeting will take place in Brown County
June 2018: Members are auto enrolled

Region IV (South Central):

April 2018: Members will receive a letter with enrollment packets.
May 14, 2018: A town hall meeting will take place in Dane County
June 2018: Members are auto enrolled